Cognitive and motor dual task gait training exerted specific training effects on dual task gait performance in individuals with Parkinson's disease: A randomized controlled pilot study.

Yea-Ru Yang,Shih-Jung Cheng,Yu-Ju Lee,Ray-Yau Wang,Yan-Ci Liu,Christine E King

doi:10.1371/journal.pone.0218180

Yea-Ru Yang, Shih-Jung Cheng + Show 4 more

Open Access

https://doi.org/10.1371/journal.pone.0218180

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Abstract

Gait impairments in Parkinson’s disease (PD) are aggravated under dual task conditions. Providing effective training to enhance different dual task gait performance is important for PD rehabilitation. This pilot study aimed to investigate the effects of cognitive and motor dual task gait training on dual task gait performance in PD. Eighteen PD participants (n = 6 per training group) were assigned to cognitive dual task gait training (CDTT), motor dual task gait training (MDTT), or general gait training (control) group randomly. The training was 30 min each session, 3 sessions per week for 4 weeks. Primary outcomes including gait performance during cognitive dual task, motor dual task, and single walking were assessed at pre- and post-training. The results showed decreased double support time during cognitive dual task walking after CDTT (-17.1±10.3%) was significantly more than MDTT (6.3±25.6%, p = .006) and control training (-5.6±7.8%, p = .041). Stride time variability during motor dual task walking decreased more after MDTT (-16.3±32.3%) than CDTT (38.6±24.0%, p = .015) and control training (36.8±36.4%, p = .041). CDTT also improved motor dual task walking performance especially on gait speed (13.8±10.71%, p = .046) stride length (10.5±6.6%, p = .046), and double support time (-8.0±2.0%, p = .028). CDTT improved single walking performance as well on gait speed (11.4±5.5%, p = .046), stride length (9.2±4.6%, p = .028), and double support time (-8.1±3.0%, p = .028). In summary, our preliminary data showed 12-session of CDTT decreased double support time during cognitive dual task walking, and MDTT reduced gait variability during motor dual task walking. Different training strategy can be adopted for possibly different training effects in people with PD.

Highlights

Parkinson’s disease (PD) is a neurological degenerative disease which leads to motor impairments such as functional walking
The results showed decreased double support time during cognitive dual task walking after cognitive dual task gait training (CDTT) (-17.1±10.3%) was significantly more than motor dual task gait training (MDTT) (6.3±25.6%, p = .006) and control training (-5.6±7.8%, p = .041)
Different training strategy can be adopted for possibly different training effects in people with PD

Summary

Introduction

Parkinson’s disease (PD) is a neurological degenerative disease which leads to motor impairments such as functional walking. Dual task walking is one of the functional walking that is essential for daily life. It has been reported that gait impairments in people with PD are noticeable under dual task conditions included decreased gait speed and stride length and increased stride-to-stride variability[1,2,3,4]. During dual task walking, the attention may need to engage in performing the secondary task, leaving responsibility for regulating the more automatic walking task to the defective basal ganglia circuitry. Gait speed decreased and gait automaticity as indicated by the stride variabilities increased in people with PD during dual task walking as compared to their usual walking [4]. The interference of secondary task during walking may lead to risks of falls during different dual task walking [2]

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